Active NPI
Tracey M Easterling, N.P.
- Adult Health Nurse Practitioner
- Canyon Country, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 95006200
- Practice address
- 14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200 - Phone
- (661) 250-5200
- Fax
- (661) 510-5210
- NPI assigned
- Apr 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95006200 | CA | |
| Adult Health Nurse Practitioner | 363LA2200X | 95006200 | CA | Primary |
Addresses
Primary practice location
14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200
Mailing address
PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
27107 Tourney Rd
Santa Clarita, CA 91355-1860
Phone (661) 222-2323
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Memorialcare Medical Foundation | Nurse Practitioner | Current | Accepting new patients |
| Cloud Health Medical Group of California, P.C. | Past | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
Interoperability endpoints
- teasterling720270@direct.memorialcare.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Panorama City, CA
- NPI 1407888928
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1194404327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1992230478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9602",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913469602",
"telephone_number": "818-837-5559",
"fax_number": "818-792-4793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14550 SOLEDAD CANYON RD",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913872200",
"telephone_number": "661-250-5200",
"fax_number": "661-510-5210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTERLING",
"first_name": "TRACEY",
"middle_name": "M",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-21",
"last_updated": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95006200",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "95006200",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "13652 Cantara St",
"city": "Panorama City",
"state": "CA",
"country_code": "US",
"postal_code": "914025423",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Canyon Country, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.